The American journal of emergency medicine
-
Case Reports
Nebulized ketamine to avoid mechanical ventilation in a pediatric patient with severe asthma exacerbation.
Asthma is a major cause of morbidity and mortality despite advances in outpatient treatment. Sometimes, children fail to respond to standard treatment and can potentially require mechanical ventilation. We describe a case of a 26-month-old girl with a severe asthma exacerbation successfully managed by ketamine administration via nebulization route that permitted to avoid mechanical ventilation. Nebulized ketamine might be a reasonable option to avoid mechanical ventilation in children who fail to respond to standard treatment of severe asthma exacerbation.
-
Review Meta Analysis
Prevalence of pulmonary embolism in patients presenting with syncope. A systematic review and meta-analysis.
Syncope is a common clinical presentation and establishing an etiology is often challenging. Pulmonary embolism (PE) has been thought to be an uncommon cause but a recent report suggested otherwise. ⋯ The estimated prevalence of PE in patients presenting with syncope is low. The Prandoni et al. estimates are significantly higher, suggesting a possible site effect, accrual bias, or investigation strategy. These and the prognostic impact of higher PE prevalence require understanding before changes in practice.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of intravenous dexketoprofen trometamol, fentanyl, and paracetamol in the treatment of patients admitted to the emergency department for renal colic: A randomized controlled trial.
In this study, we aimed to compare the analgesic efficacy of intravenous dexketoprofen trometamol, fentanyl, and paracetamol in patients presenting to the emergency department with renal colic. ⋯ As a Non-steroidal antiinflammatory drug dexketoprofen trometamol is superior to paracetamol and fentanyl in achieving analgesia and reducing the need for additional drugs for the treatment of renal colic.
-
Randomized Controlled Trial Comparative Study
Utility of a Medical Alert Protection System compared to telephone follow-up only for home-alone elderly presenting to the Emergency Department - A randomized controlled trial.
Medical Alert Protection Systems (MAPS) are a form of assistive technology designed to support independent living in the care of elderly patients in the community. We aimed to investigate the utility of using such a device (eAlert! System) in elderly patients presenting to an Emergency Department (ED). ⋯ In this population of elderly ED patients, the use of a MAPS decreased length of stay for admissions and improved quality of life measures.
-
Multicenter Study Observational Study
Blood pressure variability as an indicator of sepsis severity in adult emergency department patients.
Quantify the correlation between blood pressure variability (BPV) and markers of illness severity: serum lactate (LAC) or Sequential Organ Failure Assessment (SOFA) scores. ⋯ With the finding of a positive correlation between BPV and markers of illness severity (LAC and SOFA scores), this pilot study introduces BPV analysis as a real-time, non-invasive tool for continuous sepsis monitoring in the ED.